On meeting the Enemy

In his practically inimitable fashion, Jon Udell interconnects problems and solutions and possibilities that provoke one to unexpected musings. This time it begins with the problems of relaying snippets of audio, but the broader context is the Grand Problem of ?whose responsibility should it be? to undertake analysis and management of Really Big Questions.

…while I endorse Shannon Brownlee’s analysis [9:13 RealAudio, and really worth a listen], I don’t buy her concluding appeal for a new federal agency to collect and analyze information about health care delivery and outcomes. I wouldn’t expect the government to do that any more than I’d hold Google and Microsoft and Yahoo! responsible for taming the cornucopia of general information and knowledge. We produce those goods. We’ll be rewarded when we make them well-structured, well-connected, and therefore discoverable. And we’ll be punished when we don’t.

The Really Big Question in this instance is how to improve the tracking of medical information that bears on the quality of health care, including both (a) outcomes AND (b) effectiveness of treatment. Information gathering and analysis can’t be left to “the market” (that is, to health care insurers, drug companies, other profit-driven actors) –it needs to result in public information, and it has to be national in scope. What, I ask myself, is “government” for if not to perform such grand-scale tasks of data gathering, analysis, and communication?

I surely agree with Jon’s penultimate sentence, and with his prescription of “Will, common sense, elbow grease” as necessities, but I’m flummoxed by the task of parsing the pronouns –the ‘we’ and ‘them’. The WE is surely all of us, society as a whole, the prospective beneficiaries of improvement in the sorry state of health care. The referent of THEM is …well, I guess THEM is all those pesky datums that are ill-structured and mal-connected. How do we move from WE-as-you-and-I to a WE that embraces everybody? Not like this is a new question…